The enormous quantity
of starch which he consumes, either as bread or porridge, demands a
greater activity upon the part of the pancreatic gland, and this is
directly brought about by the acid. Further, in certain affections of
the stomach, associated with loss of appetite, we make use of acids,
both from instinct as well as medical direction, the explanation being
that they excite an increased activity of the pancreatic gland, and
thus supplement the weak action of the stomach. It appears to me that a
knowledge of the special relations of acids to the pancreas ought to be
very useful in medicine, since it brings the gland--a digestive organ
at once so powerful and so difficult of access--under the control of
the physician. We could, for instance, intentionally discard digestion
in the stomach, and thus transfer it to the bowel, by prescribing
substances which do not excite the gastric glands. On the other hand,
by lessening the acidity of the gastric juice we could reduce the
activity of the pancreas, and these are matters which might be made use
of in various special diseases, or even in some general disturbances of
the digestive apparatus.
No less instructive is a comparison of the results of our experiments
upon fat, with the demands of instinct and also with the precepts of
dietetics and therapeutics. Everybody knows that fatty foods are heavy,
that is, difficult of digestion, and in the case of weak stomachs
they are usually avoided. We are now in a position to understand this
physiologically. The existence of fat in large quantities in the chyme
restrains in its own interest the further secretion of gastric juice,
and thus impedes the digestion of proteid substances; consequently, a
combination of fat and proteid-holding foods is particularly difficult
to digest, and can only be borne by those who have good stomachs
and keen appetites. The combination of bread and butter is less
difficult, as might _a priori_ be inferred from its wide employment.
Bread requires for itself, especially when calculated per unit, but
little gastric juice and but little acid, while the fat which excites
the pancreatic gland insures a rich production of ferment both for
itself and also for the starch and proteid of bread. Fat alone does
not count by any means as a heavy food, as may be seen from the fact
that large quantities of lard are consumed in certain districts of
Russia with impunity. This also is comprehensible, since the inhibitory
influence of the fat in this case does not prevent the digestion of
any other food-stuff, and is conducive to the assimilation of the
fat itself. There is no struggle in this case between the several
food constituents, and therefore no one of them suffers. In harmony
also with daily experience the physician, in cases of weakness of the
stomach, totally excludes fatty food and recommends meat of a fat-free
kind; for example, game, etc. In pathological cases, however, where an
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